Older women don’t have an increased overall risk of complications from breast reconstruction after mastectomy, according to a study published in the February issue ofPlastic and Reconstructive Surgery.
“Older patients should be counselled that their age does not confer an increased risk of complications after implant-based post-mastectomy breast reconstruction,” wrote Mark Sisco, MD, NorthShore Plastic Surgery Center, and University of Chicago, Chicago, Illinois, and colleagues.
However, the results do suggest that women aged 65 years and older are at increased risk of blood clot-related complications after tissue-based breast reconstruction.
Using a national surgery database, the researchers identified nearly 41,100 women who had unilateral mastectomy between 2005 and 2012. Of these, about 11,800 patients underwent breast reconstruction. Women aged 65 or older were less likely to have breast reconstruction (10.8%) compared with younger women (39.5%).
Compared with mastectomy only, women undergoing breast reconstruction had more complications, including increased hospital days, and repeat surgeries. The complication rate after breast reconstruction was 6.8% for older women and 5.2% for younger women.
The overall risk of complications did not differ significantly between age groups, after adjustment for other factors. The risk remained the same for older and younger women undergoing breast reconstruction using implants.
However, after autologous reconstruction, the risk of venous thromboembolism (VTE) was significantly higher for older women. On adjusted analysis, VTE risk was nearly 4 times higher in women aged 65 years or older, and more than 6 times higher for those aged 70 to 75. The overall rate of VTE after autologous reconstruction was just under 1%. Other types of complications were similar between age groups.
Breast reconstruction is an important option for women undergoing mastectomy and may improve patient self-esteem, body image, and quality of life, according to the authors. Older women are much less likely to undergo breast reconstruction — partly because of a perceived increase in surgical risk.
“Older women considering implant-based reconstruction should be assured that their age is not a factor in determining the risk of complications,” the authors wrote. “However, they should be counselled that their age may confer an increased risk of VTE.”
They suggest that older women may need special attention to preventing VTE after autologous breast reconstruction, possibly including longer use of blood-thinning medications.
<h3>References</h3>
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